<%@ include file="/common/taglibs.jsp"%>

<head>
<title><fmt:message key="birthCertificate.title" /></title>
</head>

<body class="createBirth" />

<div class="span3">
	<h2>
		<fmt:message key="birthCertificate.heading" />
	</h2>
	<fmt:message key="birthCertificate.message" />
</div>
<div class="span7">
	<s:form name="createBirthForm" action="saveBirth.action"
		enctype="multipart/form-data" method="post" validate="true"
		cssClass="well form-horizontal">
		<s:hidden key="birth.id" />
		<s:hidden key="zoneId" />
		<s:hidden key="id" />

		<input type="hidden" name="from" value="${param.from}" />
		<s:label key="birth.id" />
		<s:label key="birth.motherName" />
		<s:label key="birth.motherAge" />
		<s:label key="birth.fatherName" />
		<s:label key="birth.childName" />
		<s:label key="birth.sex" />
		<s:label key="birth.email" />
		<s:label key="birth.fax" />
		<s:label key="birth.phoneNumber" />
		<s:label key="birth.mobileNumber" />
		<s:label key="birth.birthDateString" />
		<s:label key="birth.address" />
		<s:label key="birth.postalCode" />
		<s:label key="birth.country" />

		<s:if test="birth.idProof != null">
			<img
				src="showImage.action?id=<s:property value="birth.id"/>&from=list"
				border="0" width="100" height="100">
		</s:if>

		<s:submit key="button.print" method="submitBirth"
			cssClass="btn btn-primary" theme="simple" />
		<s:submit key="button.cancel" method="cancel" cssClass="btn"
			theme="simple" />
	</s:form>
</div>

